Social Work

Voices from the inside

Viviene E. Cree, Ann Davis

• Publisher: Routledge
• Year: 2007
• eBook ISBN: 9781134249510
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

Social Work: Voices from the Inside offers unique insight into social work from the perspectives of those 'on the inside', that is, service users, carers and practitioners.

Drawing on a narrative tradition, fifty-nine people from across the UK tell their stories about how and why social work came into their lives, and what happened next. Key topics are discussed, including:

children and family social work

criminal justice social work

mental health social work

residential child care

social work with disabled people

social work with older people

lessons for the future.

Focusing on issues for good practice in social work and social work education, this book is essential reading for students and academics of social work and social policy. It will also appeal to social work professionals and those in allied health, education and care areas.

Chapter 1

Voices from social work

INTRODUCTION

Our aim in writing this book is to present social work from the inside: from the perspectives of social work service users, carers and practitioners currently working and living with social work in the UK. It has been written at a time when across the four countries in the UK, social work is facing unprecedented uncertainty and change. On the one hand, social work is, for the first time, enjoying recognition of its standing alongside other professional groups. It is now a registered profession, with degree-level training. But social work is also experiencing high levels of insecurity and uncertainty. It is not at all clear where social workers are going to be employed and who will employ them in the future. In these new emerging structures and organisations, will social workers be replaced by other kinds of workers? And what will be the implications of this for those on the receiving end of services?

In the midst of this time of change, we invited a range of people to take stock: to help us to examine what people think they are delivering in the here and now, and what we might wish to take forward into the new world of social work. We therefore asked them to tell us about their journeys in and through social work practice. Whilst every story is unique, common themes emerge across the various accounts and, as authors, we have sought to contextualise these in the wider research literature so that readers may follow up the stories with further reading. Each contributor was invited to consider the positive part that social work might play in individual lives and in society as a whole, and these messages have been pulled together in the concluding chapter which provides an overview of the book.

A critical time for social work

The interviews for the book were conducted during 2005. This was a time when there were major consultations, discussions and debates about social work’s role in the past, present and future, initiated by the Department of Health, the Social Care Institute for Excellence (SCIE), the National Assembly for Wales and the Scottish Executive. These debates reflect the New Labour government’s ‘Modernising’ agenda, which has, at its heart, reform of the public sector. The overall aim of this has been expressed as ‘putting people at the centre of public services’ (Offices of Public Service Reform 2002); the underpinning belief is that services will become more effective ‘if people are enabled to become participants in the design and delivery of services and so become co-producers of the public goods they value’ (Leadbetter 2004). Of course, the drive to involve users of services has not simply been a government-inspired initiative. In recent years, carers, users of services and their organisations have led the way in challenging traditional paternalism in social work and health. Many of the recent developments in service delivery – for example, the shifts towards Direct Payments and Independent Living schemes – have come about as a direct result of campaigns by user groups (see Beresford and Croft 2004). Likewise, Davis (2006) and others have argued that service users and carers must in future be seen as active, knowledgeable agents, rather than passive recipients of services.

‘Modernising’ social services has not only been about user participation (see Cree 2002). It has, just as crucially, been concerned with breaking down the organisational barriers which existed between services, and creating ‘new shared ways of delivering services that are individually tailored, accessible and more joined up’ (Department of Health 2000: 30). The consequence for social work and social services in 2005 has been a whole-scale restructuring of service delivery and, with it, the demise of local authority social services and social work departments. As services for adults and children throughout the UK have become separated, so adult services are increasingly managed by departments of health, and children and family services by departments of education. These developments challenge the integrated nature of the social work profession and add to a sense of fragmentation and uncertainty. Questions have been asked about whether social work can survive in the new world. Whatever happens, the whole organisation and delivery of social work services in the future are set to look very different from social work in the past.

This was also a time of consolidation for social workers and the social work profession in the UK. After a long campaign waged over the last 25 years by professional bodies including the British Association of Social Workers (BASW) and the Central Council for Education and Training in Social Work (CCETSW), legislation was passed in 2000 and 2001 which regulated the social work profession for the first time. The Care Standards Act 2000 and Regulation of Care (Scotland) Act 2001 required that all qualified social workers should be registered. Social workers were invited to register from 1 April 2003; then from 1 April 2005 (England, Wales and Northern Ireland) and 1 September 2005 (Scotland), the title of social worker was protected for the first time, so that only those with an ‘entitling qualification’ could call themselves social workers. The registration of social workers will undoubtedly strengthen the profession, by giving social workers the same status as other professional groups such as teachers, nurses and doctors. It will also, it is hoped, act as a safeguard for users of services, and add to the general public’s confidence in social work.

All of the changes we have highlighted demonstrate that this is a book of its time; it inevitably captures a moment – a moment when we know where we have come from, but cannot be certain where we are going. This does not suggest, however, that the fundamental social work practice which the book describes is likely to change quickly. On the contrary, the stories which the service users, carers and practitioners have shared with us are, in many ways, timeless, because it is clear that good practice in social work remains constant, while structures and organisations may change.

Some thoughts about terminology

It should be noted from the outset that the terms ‘service user’, ‘carer’ and ‘practitioner’ are all potentially unhelpful and may be misleading; the differences between these groups may, at times, be more apparent than real, as we will discover.

The term ‘service user’ has been used for a number of years in preference to the term ‘client’ as a convenient and neutral shorthand expression to denote those who are receiving social work services. However, many people who use services have not wished to be defined in this way, finding the term, at least, clumsy, and, at worst, derogatory and even oppressive. Those who use services are not a homogeneous group, as this book will demonstrate. They come from all classes and cultures; they are young and old, female and male, with disabilities and without. Neither are they only ‘service users’; any one of us may need to access social services for a particular reason, but this is not our primary identity. What unites service users is that, for a time, they have individually (or as family members) accessed the services of social work. Some service user groups have introduced the term ‘experts by experience’ as a better way of defining their contribution (see Preston-Shoot 2005). We have continued to use the term ‘service user’ simply because it is more familiar in public usage.

The term ‘carer’ brings similar complications. From the 1960s onwards, there was an upsurge of interest in the notion of caring, reflecting wider political, social and economic changes that were taking place (Cree 2000). Social scientists and feminist researchers drew attention to the reality that what was being championed by successive governments as ‘community care’ was actually an unpaid and unseen domestic service performed largely by women. The 1980s therefore witnessed an explosion of concern for the experience of carers, at exactly the same time as disability rights campaigners instigated a movement for civil rights for people with disabilities. The consequence of both these developments has been the creation of a better understanding of the meaning of care, both to care-givers and to care-recipients. It has been acknowledged that caring is a complex, interconnected and changing experience in which people care for each other in different ways, at different times. What this implies for our own discussion is that the word ‘carer’ is not a straightforward, factual one. In practice, carers may also be cared for by those for whom they are caring, and the impact of class, gender, ‘race’/ethnicity and other structured inequalities plays a major role in determining the quality and nature of that caring relationship.

We have argued that the terms ‘service user’ and ‘carer’ must not be taken at face value; neither should the term ‘social worker’. We have already stated that ‘social worker’ is now a protected title in the UK. In writing this book, we have deliberately chosen the term ‘social work practitioner’ in preference to this, in order to acknowledge that there are many people practising in social work who are not called social workers. So, for example, the residential workers and leaving care team staff whom we interviewed are not called social workers. Nevertheless, the stories in this book are, with only one exception, the stories of those with professional social work qualifications who are working in different practice settings. Whilst we do not wish to minimise the contributions of the very many social work assistants, day-care staff and youth workers working in social services, this was not our primary focus in this book.

Terminology impacts on the contents of the book, as well as the titles of the contributors. Language is a hugely contested area, in social work as in other disciplines. Terms such as ‘mental illness’, ‘disability’ and ‘offender’ are highly emotive and will, at different points in time, carry different meanings and nuances. We have tried, wherever possible, to be sensitive to the language that service users and carers prefer to use to describe their experiences. This means that at times, language may be used which is no longer the preferred terminology within a professional group. One example of this is the word ‘sectioned’, which service users have used in their accounts to describe the experience of being hospitalised under mental health legislation.

There is one final point to be made here. In pulling together the accounts in the book, we have been struck by the reality that people’s experiences are often overlapping and contradictory; their identities are not static, but are constantly changing. Hence someone who is, today, a service user, may train to become a social worker tomorrow; someone who is employed in social work may, at the same time, be a carer and possibly also a user of social services. This suggests that we must approach the book with some caution, and with a large measure of respect for the multi-layered, complex lives which people lead.

STRUCTURE OF THE BOOK

The book is structured around six broad areas of social work practice which are presented alphabetically:

• children and families’ social work
• criminal justice social work
• mental health social work
• residential child care
• social work with disabled people
• social work with older people.

These areas reflect the reality of the organisation of social work practice in the UK to some degree, but they are not discrete categories. Nor do they constitute the only service user groups with whom social work is involved. There is, as is widely recognised, a large measure of overlap between social work with disabilities and mental health social work; likewise between mental health social work and social work with older people, particularly around the subject of dementia. At the same time, topics such as social work in the fields of addictions and youth justice have only received passing mention and deserve further consideration in the future. In writing the book, however, we had to start somewhere, and we believe that the range of work covered by these six broad areas allows the reader to build a reasonably accurate picture of social work as it is practised in the UK today.

The setting for the book, as stated, is social work in the UK. Interviews were conducted in Belfast, Cardiff, Edinburgh, Fife, London, the Midlands of England and Yorkshire. This is not to suggest that social work is the same across the UK; it is clearly not, as demonstrated by the inclusion of a chapter on criminal justice social work. We believe, however, that by taking readers into very specific examples of social work in different parts of the UK, we will give them access to more generalisable ideas about social work, and about its impact on service users, carers and practitioners wherever the setting.

CONTEXT OF THE BOOK

There is a rich mixture of material available which considers social work from the perspectives of service users, carers and practitioners.

Over the last 10 years or so, a number of edited books and anthologies of users’ and carers’ accounts have been published. For example, Read and Reynolds’ (1996) collection provides a useful example of mental health service users’ accounts of the services they had received, both in hospital and the community, and offers clear pointers as to what people want from mental health services in the future. More recently, Malone et al.’s (2005) anthology provides first-hand stories of how service users, carers and care professionals have experienced their everyday interactions, as well as examples of works of fiction which also provide another perspective on the issues raised.
The involvement of service users and carers cannot, Beresford and Croft argue, be understood in isolation:

It needs to be understood in the much broader context of the development of movements of health and social care service users, including the disabled people’s and mental health service users’/survivors’ movements . . . The focus of these movements has extended far beyond social work, social care and welfare into broader political, economic, social and cultural spheres.

(2004: 62)

Recent SCIE reports (Social Care Institute for Excellence 2004a and 2004b) review the contribution that service user participation has made to social care services and to social work education. Whilst these reports identify that the involvement of service users and carers has been patchy, and is yet to be properly evaluated, nevertheless they demonstrate that participation is already challenging traditional professional modes of thinking and operating in a constructive way. As an example of this, the international journal Social Work Education invited an editorial collective of service users, carers and academics to produce a special issue dedicated to user involvement in social work education in 2006.

Just as there is current interest in service user and carer perspectives, so there has been renewed commitment to explore the experiences of those in the social care workforce. This has taken the form of both academic research and government review. Balloch et al.’s (1999) study of social workers in local authority social services departments uncovered evidence of high levels of stress and vulnerability to physical attacks. The study also, however, identified a relatively stable and committed workforce, which, on the whole, embraced change as offering positive opportunities and growth. Jones’s (2001) research into social services department staff in England was less optimistic. He described the social workers whom he interviewed as stressed by their agencies, and social work as a ‘factory through which people are processed’. More recently, Huxley et al. (2005) surveyed the stress and pressures experienced by mental health social workers and concluded that although the social workers in their study valued face-to-face contact with clients, they did not feel valued by their employers and society. This, they argue, is likely to lead to retention problems.

In contrast to this evidence of how social workers view their situation, a survey of public attitudes towards social work in Scotland found that the profession has a broadly positive profile (Davidson and King 2005). Of those who had used social work services, 78 per cent were said to be satisfied with the services they received and 69 per cent indicated that social services were quick to respond to their needs. Half of those surveyed agreed that they understood the role of social workers (37 per cent felt they did not understand the role) and 42 per cent of respondents had a positive or very positive perception of the work (with 24 per cent having a negative perception). Throughout the survey, research participants made references to staff shortages and there was recognition that social workers are required to undertake a wide range of difficult tasks and that some of th...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Chapter 1: Voices from social work
• Chapter 2: Children and families’ social work
• Chapter 3: Criminal justice social work
• Chapter 4: Mental health social work
• Chapter 5: Residential child care
• Chapter 6: Social work with disabled people
• Chapter 7: Social work with older people
• Chapter 8: Lessons for the future